Current and future approaches for control of graft-versus-host disease.
Current and future approaches for control of graft-versus-host disease.
复制标题
DOI：
10.1586/17474086.1.1.111
复制
发表时间：
2008-10
影响因子：
2.8
通讯作者：
Antin JH
中科院分区：
文献类型：
--
作者：
Koreth J;Antin JH
急性和慢性移植物抗宿主病（GVHD）仍然是改善异基因干细胞移植后结局的主要障碍之一。GVHD的病理生理学是复杂的并且不完全理解。GVHD被认为是由以下因素的相互作用引起的：组织损伤和促炎细胞因子引起抗原呈递细胞（APC）的活化，APC和细胞因子引起的供体T细胞活化，以及效应T淋巴细胞和促炎细胞因子引起的宿主组织损伤。另外的淋巴细胞亚型（初始和记忆T细胞、调节性T细胞、自然杀伤T细胞和B细胞）在GVHD发病机制中也有作用。改善供体-受体HLA匹配，并使条件毒性、细胞因子释放、APC和效应T淋巴细胞活化最小化的策略可能会改善急性（和可能的慢性）GVHD的预防。已确诊的急性和慢性GVHD的治疗仍然严重依赖皮质类固醇，尽管它们的功效有限且毒性相当大。包括靶向参与免疫活化的特定步骤或亚组的药理学、生物学和细胞疗法的新型药剂（和/或药剂组合）将可能包括GVHD控制的未来进展。本文就急性和慢性GVHD的预防和治疗现状作一综述。还强调了目前正在评估的新方法。
Graft-versus-host disease (GVHD), both acute and chronic, remains one of the major barriers to improving outcomes after allogeneic stem cell transplantation. The pathophysiology of GVHD is complex and incompletely understood. GVHD is believed to arise from the interaction of: tissue damage and proinflammatory cytokines causing activation of antigen-presenting cells (APCs, donor T-cell activation by APCs and cytokines and host tissue injury by effector T lymphocytes and proinflammatory cytokines. There is also a role for additional lymphocyte subtypes (naive and memory T cells, regulatory T cells, natural killer T cells and B cells) in GVHD pathogenesis. Strategies to improve donor–recipient HLA match, and to minimize conditioning toxicity, cytokine release and APC and effector T-lymphocyte activation, will likely improve prophylaxis of acute (and possibly chronic) GVHD. Therapy of established acute and chronic GVHD is still heavily dependent on corticosteroids, despite their limited efficacy and considerable toxicity. Novel agents (and/or combinations of agents) comprising pharmacologic, biologic and cellular therapies targeting specific steps or subsets involved in immune activation will likely comprise future advances in GVHD control. This article reviews the current state of knowledge regarding the prevention and treatment of acute and chronic GVHD. Novel approaches currently undergoing evaluation are also highlighted.
登录
查看更多内容
影响因子：
64.8
作者：
Bettelli, E;Carrier, YJ;Kuchroo, VK
通讯作者：
Kuchroo, VK
影响因子：
20.3
作者：
Antin, JH;Kim, HT;Soiffer, RJ
通讯作者：
Soiffer, RJ
影响因子：
2.6
作者：
Bartholomew, A;Sturgeon, C;Hoffman, R
通讯作者：
Hoffman, R
影响因子：
20.3
作者：
ANTIN, JH;WEINSTEIN, HJ;FERRARA, JLM
通讯作者：
FERRARA, JLM
DOI：
10.1053/bbmt.2001.v7.pm11400948
发表时间：
2001-01-01
影响因子：
4.3
作者：
Arora, M;Wagner, JE;Weisdorf, DJ
通讯作者：
Weisdorf, DJ